The NIH Stroke Trials Network (StrokeNet) is designed to maximize efficiencies to prioritize, harmonize and streamline the development of high-quality, multi-site clinical trials focused on key interventions in stroke prevention, treatment, and recovery. The StrokeNet Regional Coordinating Center (RCC) at the University of Pittsburgh (STN-UP) plans to continue its successful clinical trials structure with improvements based upon our experiences during the initial term of RCC funding. The aims of this proposal to continue as STN-UP are: 1: To continue to build on our strengths as a dynamic, collaborative and sustainable administrative structure to rapidly implement stroke clinical trials and enroll patients across a wide range of adult and pediatric populations. 2: To foster participation of physicians, patients and patient support groups in the STN-UP. 3: To promote career development of young clinician-investigators in the neurosciences STN-UP will be led by the Program Director, Lawrence Wechsler, MD, co-Program Director Tudor Jovin, MD. Strengths of the STN-UP to continue participation as an RCC in the NIH StrokeNet are: 1) Consistent track record of high enrollment in NINDS and industry clinical trials. 2) Over 2000 yearly stroke admissions at three University of Pittsburgh Medical Center (UPMC) core hospitals (UPMC Presbyterian, UPMC Shadyside, and UPMC Mercy) 3) Large telestroke network including 28 hospitals in western Pennsylvania and Maryland with prior experience recruiting patients into stroke trials after telemedicine evaluation. 4) Extensive regional referral network with phone support to hospitals throughout the tri-state area. 5) Participation in StrokeNet, NETT and NeuroNEXT networks, and institutional support for tier-1 federated IRB and master clinical trial agreements. To continue the commitment of training the ?next generation? of qualified stroke researchers, the STN-UP will: 1) Maintain our dedicated clinician researcher-oriented fellowship. 2) Recruit trainees to the Advisory Committee on a rotating basis. 3) Provide clinical trials education and experience for residents, fellows and junior faculty.